Perioperative Hyperglycemia: A Literature Review

Peacock, Tammy S.

doi:10.1002/aorn.12445

Cited by 17 publications

(10 citation statements)

References 21 publications

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“…Cannot specify exact cause for this hyperglycemia in all cases. However, previous studies have demonstrated that surgical trauma can increase the stress hormone cortisol, along with catecholamines, which can induce insulin resistance, finally resulting in hyperglycemia (Duggan et al 2017;Peacock 2019).…”

Section: Discussionmentioning

confidence: 99%

The Effects of Acute Blood Loss on Inflammatory and Bone Biomarkers, Acid-base Balance, Blood Gases and Hemato-biochemical Profiles in Sedated Donkeys (Equus asinus)

2022

Int J Vet Sci

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The current experiment was designed to investigate the possible effects of acute blood loss on the inflammatory and bone biomarkers status, acid-base balance, blood gases, and hemato-biochemical profiles in sedated donkeys (Equus asinus). For the induction of acute blood loss, collected 900mL of blood from the carotid artery of 10 male donkeys sedated with xylazine HCl (1mg/kg). For analysis, five blood samples were collected; collected the 1st (T0) before induction of blood loss and the other 4 (T1, T2, T3 and T4) collected at 30, 60, 120 and 240min post-blood loss. The serum concentrations of amyloid A (SAA) and haptoglobin (Hp) decreased at all-time points after blood loss compared to T0, but the differences were non-significant. The differences in levels of serum biomarkers osteocalcin (OC), β-alkaline phosphatase (β-ALP) and pyridinoline cross-links (PYD) at all-time points post blood loss compared to T0 values were also non-significant. Except for PCO2, the acid-base status and blood gases, including pH, PO2, HCO3, TCO2, sO2, base excess, anion gap and lactate, increased significantly after blood withdrawal. On the contrary, most of the measured hemato-biochemical parameters decreased significantly after blood loss, except for glucose. In conclusion, acute blood loss in sedated donkeys did not influence serum concentrations of the inflammatory biomarkers SAA and Hp and the markers of bone metabolism OC, β-ALP, and PYD. On the contrary, most acid-base, blood gas parameters, and hemato-biochemical parameters differed significantly after blood withdrawal compared to their values before blood loss.

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Section: Discussionmentioning

confidence: 99%

The Effects of Acute Blood Loss on Inflammatory and Bone Biomarkers, Acid-base Balance, Blood Gases and Hemato-biochemical Profiles in Sedated Donkeys (Equus asinus)

2022

Int J Vet Sci

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“…Hyperglycemia is associated with an activated inflammatory system and leads to organ damage 1 . Perioperative hyperglycemia is common in surgical patients and is associated with poor postoperative clinical outcomes 2–5 . Perioperative hyperglycemia is common in cardiac surgery owing to highly invasive procedures and cardiopulmonary bypass (CPB) 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Effect of intensive insulin therapy on inflammatory response after cardiac surgery using bedside artificial pancreas: A propensity score‐matched analysis

et al. 2022

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Background: Perioperative hyperglycemia leads to poor postoperative clinical outcomes, including compromised immune function, cardiovascular events, and mortality. The optimal perioperative blood glucose levels during cardiac surgery remain unclear. A closed-loop glycemic control system (artificial pancreas, target blood glucose range:120-150 mg/dl) prevents postoperative inflammatory response more effectively than conventional insulin therapy (<200 mg/ dl). However, the clinical effects of intensive insulin therapy with strict glycemic control (80-110 mg/dl) are controversial. This study aimed to determine whether intensive insulin therapy would further suppress postoperative inflammatory reactions.Methods: This study analyzed 262 patients who underwent cardiovascular surgery with cardiopulmonary bypass. The patients were divided into two groups according to their target blood glucose range: 80-110 mg/dl and 120-150 mg/dl. The primary outcome was the difference in the C-reactive protein levels between the two groups.Results: Propensity score matching resulted in 95 patients in each group based on their covariates. There was no difference in the postoperative maximum C-reactive protein levels between the two groups (14.81 ± 5.93 mg/dl vs. 14.34 ± 5.52 mg/dl; p = 0.571) following propensity score matching. Hypoglycemia did not occur during intensive insulin therapy. Conclusions:Intensive insulin therapy following cardiac surgery with cardiopulmonary bypass did not demonstrate significant advantages in the suppression of postoperative inflammatory reactions compared to that with mild glycemic control. However, intensive insulin therapy using an artificial pancreas was found to be safe, with no hypoglycemic events.

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“…Diabetes mellitus is a prevalent metabolism disorder displayed as hyperglycemia. Long-term hyperglycemia is a risk factor of endocrine disease development because of defi ciency in insulin resistance and/or release (1). Along with advancement of living standards, the incidence and morbidity of diabetes mellitus increases gradually in humans globally, and the number of diabetic patients is estimated to rise to 592 million in 2035 (2).…”

Section: Introductionmentioning

confidence: 99%